WO2021004229A1 - Nouvelle application de l'inhibiteur du récepteur de chimiokine ccr6 dans la prévention de la récurrence du psoriasis - Google Patents
Nouvelle application de l'inhibiteur du récepteur de chimiokine ccr6 dans la prévention de la récurrence du psoriasis Download PDFInfo
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- WO2021004229A1 WO2021004229A1 PCT/CN2020/095956 CN2020095956W WO2021004229A1 WO 2021004229 A1 WO2021004229 A1 WO 2021004229A1 CN 2020095956 W CN2020095956 W CN 2020095956W WO 2021004229 A1 WO2021004229 A1 WO 2021004229A1
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- Prior art keywords
- psoriasis
- pharmaceutical composition
- recurrence
- cells
- ccr6
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Definitions
- the invention relates to the field of biomedicine, in particular to the new application of chemokine receptor CCR6 inhibitors in preventing the recurrence of psoriasis.
- Psoriasis is a typical of common inflammatory skin diseases, with an incidence of about 2%-3% worldwide, and recurrence is its characteristic. Plaque type is the most common type of psoriasis, accounting for about 90% of all psoriasis patients. It is manifested as papules and scaly erythema with clear boundaries, often symmetrically distributed on the scalp, limbs, and trunk.
- the pathogenesis of psoriasis is currently unclear. Genetic susceptibility, environmental triggers, skin barrier function destruction and immune system dysfunction are all involved, and different cells participate in different stages of disease occurrence, development, stability, and recurrence.
- the classic treatment methods for psoriasis include mild to moderate topical medications such as emollients, glucocorticoids, vitamin D derivatives, and moderate to severe systemic treatments such as phototherapy, methotrexate, cyclosporine, and albino Dimension A.
- the main immunological event in psoriasis is the activation of skin keratinocytes by inflammatory factors such as TNF-a, IL-23 and IL17. It has been reported that the key pathogenic product of psoriasis is IL-17. As a result, methods for targeted treatment of psoriasis for cytokines have emerged.
- biologics are a major innovation in the treatment of psoriasis, a considerable number of patients use biologics to achieve remission in the initial stage, and gradually lose their efficacy as the treatment time increases, leading to recurrence of the disease, and some even progress to more serious silver.
- Types of soria such as pustular, erythroderma and joint psoriasis.
- topical glucocorticoids have the longest history and are the most widely used. Both physicians and patients are more troubled by their recurrence after stopping the drug and the recurrence and aggravation during their continued use.
- the purpose of the present invention is to provide a therapy for preventing the recurrence of psoriasis during the treatment of psoriasis.
- chemokine receptor CCR6 inhibitor for preparing a preparation or composition, which is administered to a subject to prevent Recurrence of psoriasis.
- the subject is a mammal.
- the mammals include human or non-human mammals.
- the non-human mammals include rodents (such as rats and mice) and primates (such as monkeys).
- the subject is a patient with psoriasis.
- the subject is a patient who has experienced recurrence of psoriasis.
- the chemokine receptor CCR6 inhibitor includes: extracellular soluble fragments of CCR6, blocking antibodies, small molecule compounds, antisense nucleic acids, or combinations thereof.
- a pharmaceutical product for preventing the recurrence of psoriasis including:
- a first pharmaceutical composition comprising (a1) a chemokine receptor CCR6 inhibitor, and (a2) a first pharmaceutically acceptable carrier;
- a second pharmaceutical composition comprising (b1) other drugs or active ingredients that can be used to treat psoriasis other than CCR6 inhibitors, and (b2) a second pharmaceutically acceptable Accepted carrier.
- the (b1) other drugs or active ingredients that can be used to treat psoriasis other than CCR6 inhibitors include: glucocorticoids, including IL-17A antagonists, TNF-a antagonists Agents, IL-12/IL-23 antagonists, calcineurin inhibitors, vitamin D3 derivatives, or combinations thereof.
- component (a1) accounts for 0.01-99.99 wt% of the total weight of the first pharmaceutical composition, preferably 0.1-90 wt%, more preferably 1 -80wt%.
- the concentration of component (a1) is 10 mg/ml-1000 mg/ml, preferably 20-500 mg/ml, more preferably 50-200 mg/ml.
- component (b1) accounts for 0.01-99.99 wt% of the total weight of the second pharmaceutical composition, preferably 0.1-90 wt%, more preferably 1 -80wt%.
- (b1) is a glucocorticoid, and (b1) accounts for 0.01-50 wt% of the total weight of the second pharmaceutical composition, preferably 0.01-10wt%, more preferably 0.1-5wt%.
- the (b1) in the second pharmaceutical composition, is an IL-17A antagonist, and the concentration of (b1) in the second pharmaceutical composition is 1-1000 mg/ml , Preferably 5-500mg/ml, more preferably 10-100mg/ml.
- the first pharmaceutical composition is liquid, solid, or semi-solid.
- the dosage form of the first pharmaceutical composition is an oral dosage form, an injection, or an external pharmaceutical dosage form.
- the dosage form of the first pharmaceutical composition includes a tablet, a granule, a capsule, an oral liquid, or an injection.
- the first pharmaceutical composition is an oral preparation.
- the carrier is selected from the following group: infusion carrier and/or injection carrier, preferably, the carrier is one or more carriers selected from the group: physiological saline, glucose Salt water, or a combination thereof.
- the second pharmaceutical composition is liquid, solid, or semi-solid.
- the dosage form of the second pharmaceutical composition is an oral dosage form, an injection, or a topical pharmaceutical dosage form.
- the second pharmaceutical composition is an external pharmaceutical dosage form.
- the dosage form of the second pharmaceutical composition includes a tablet, a granule, a capsule, an oral liquid, or an injection.
- the second pharmaceutical composition is an oral preparation.
- first pharmaceutical composition and the second pharmaceutical composition in the pharmaceutical product can be made into the same dosage form or different dosage forms.
- first pharmaceutical composition and the second pharmaceutical composition in the pharmaceutical product can be administered to the subject simultaneously or sequentially.
- a pharmaceutical product including:
- a first container and a first pharmaceutical composition in the first container, the first pharmaceutical composition comprising (a1) a chemokine receptor CCR6 inhibitor, and (a2) a first pharmaceutically acceptable Accepted vehicle;
- a second container and a detection agent in the second container for detecting a substance selected from the group consisting of IL-17, ⁇ T17 cells, CD3 + T cells, CCL20 in a sample derived from a subject , CCR6, and combinations thereof.
- the sample includes: blood, skin tissue, drainage and distal lymph node tissue or a combination thereof.
- the detection includes qualitative detection and quantitative detection.
- the pharmaceutical product further includes an instruction, and the instruction records:
- the normal value refers to a value measured in a normal individual.
- the normal individual refers to an individual who does not suffer from psoriasis, or an individual who has not relapsed after psoriasis treatment.
- a method for preventing the recurrence of psoriasis is provided by administering the pharmaceutical product as described in the third or fourth aspect of the present invention to a desired subject.
- Figure 1 shows the three time points before and after halometasone treatment and the recurrence of psoriasis: flow cytometry showed that the proportion of IL-17 producing cells in peripheral blood increased after treatment and decreased when recurrence; skin lesions IL-17 produced T cells The proportion of (T17 cells) decreased after treatment and increased when recurrence; transcriptome sequencing (RNA-seq) showed that the expression of many genes in the skin lesions of patients with psoriasis changed, especially chemokines such as CCL20, CCL5, CCL2 CXCL10 decreased after treatment and increased when recurring.
- chemokines such as CCL20, CCL5, CCL2 CXCL10 decreased after treatment and increased when recurring.
- Figure 2 shows that in mice treated with halometasone topical treatment of ear skin inflammation, the symptoms of skin psoriasis were significantly alleviated, but the proportion of ⁇ T17 cells in the drainage and distal lymph nodes was significantly increased.
- Figure 3 shows that when psoriasis is induced again, mice treated with halometasone quickly relapsed, and the proportion of ⁇ T17 cells in the drainage and distal lymph nodes decreased significantly.
- Figure 4 shows the simultaneous treatment of wild-type (WT) and CCR6 -/- mice with GC. Compared with WT mice, CCR6 -/- mice not only showed reduced psoriasis symptoms, but also did not increase the proportion of ⁇ T cells in lymph nodes after halometasone treatment.
- Figure 5 shows that halometasone can quickly and effectively control psoriasis, but the disease is easy to relapse. After treatment, the expression of psoriasis-related genes decreases, and the expression is up-regulated when recurrence.
- Figure 6 shows that the proportion of distal lymph node ⁇ T and its subgroups V ⁇ 4 and V ⁇ 4V ⁇ 4 T cells and the proportion of IL-17 secreted after stimulation are higher after halometasone treatment.
- Figure 7 shows that the proportion of ⁇ T17 cells in the lymph nodes of mice in the halometasone treatment group is still significantly increased after withdrawal.
- Figure 8 shows that the proportion of ⁇ T17 cells in the lymph nodes of the halometasone-treated group mice is still significantly increased after stimulation.
- Figure 9 shows that psoriasis was induced again.
- the proportion of V ⁇ 4 and V ⁇ 4V ⁇ 4 T cells in the skin was higher in the GC group, but there was mild or no change in the lymph nodes.
- Figure 10 shows that when psoriasis recurred after GC treatment, compared with wild-type mice, CCR6ko mice still showed milder psoriasis symptoms, and there was no decrease in the proportion of ⁇ T17 cells in the lymph nodes of the GC group.
- Figure 11 shows that the use of FTY720 makes ⁇ T17 cells no longer migrate from the draining lymph nodes, and the mice in the GC group no longer have rapid recurrence of psoriasis.
- Figure 12 shows whether the imiquimod that induces the recurrence of psoriasis is replaced with mannan, and the mice in the GC group no longer have rapid disease recurrence.
- the present inventors used the mouse psoriasis model induced by imiquimod (IMQ) to simulate the whole process of external use of glucocorticoids for psoriasis patients to treat the disease-withdrawal-disease recurrence.
- IMQ mouse psoriasis model induced by imiquimod
- GC mouse psoriasis model induced by imiquimod
- mice previously treated with GC showed more severe disease recurrence, including faster epidermal thickening and more infiltration of neutrophils.
- the proportion of ⁇ T17 cells in the drainage and distant lymph nodes was no different or even lower than that of the control.
- mice with CCR6 gene knockout did not affect the redistribution of ⁇ T17 cells in the body and thus did not lead to recurrence of psoriasis. Further research found that this type of ⁇ T17 cells with migration ability have memory cell properties. In summary, the inventors found that inhibiting the redistribution of ⁇ T17 cells has a key role in controlling the recurrence of skin inflammation.
- the present invention provides a pharmaceutical composition
- a pharmaceutical composition comprising a pharmaceutically acceptable carrier and an effective amount of the following active ingredients: chemokine receptor CCR6 inhibitor and other drugs for treating psoriasis or their active ingredients.
- an effective amount or “effective dose” refers to an amount that can produce function or activity on humans and/or animals and can be accepted by humans and/or animals.
- pharmaceutically acceptable ingredients are substances that are suitable for humans and/or mammals without excessive adverse reactions (such as toxicity, irritation, and allergic reactions), that is, substances with a reasonable benefit/risk ratio.
- pharmaceutically acceptable carrier refers to a carrier for the administration of a therapeutic agent, including various excipients and diluents.
- the pharmaceutical composition of the present invention contains a safe and effective amount of the active ingredient of the present invention and a pharmaceutically acceptable carrier.
- a pharmaceutically acceptable carrier include (but are not limited to): saline, buffer, glucose, water, glycerol, ethanol, and combinations thereof.
- the pharmaceutical preparation should match the mode of administration, and the dosage form of the pharmaceutical composition of the present invention is an injection.
- it can be prepared by conventional methods with physiological saline or an aqueous solution containing glucose and other adjuvants.
- the pharmaceutical composition should be manufactured under aseptic conditions.
- the effective amount of the active ingredient of the present invention can vary with the mode of administration and the severity of the disease to be treated.
- the selection of the preferred effective amount can be determined by a person of ordinary skill in the art based on various factors (for example, through clinical trials).
- the factors include, but are not limited to: the pharmacokinetic parameters of the active ingredients such as bioavailability, metabolism, half-life, etc.; the severity of the disease to be treated by the patient, the patient's weight, the patient's immune status, and administration Way etc. For example, due to the urgent need to treat the condition, several divided doses can be given every day, or the dose can be reduced proportionally.
- the pharmaceutically acceptable carriers of the present invention include (but are not limited to): water, saline, liposomes, lipids, proteins, protein-antibody conjugates, peptides, cellulose, nanogels, or Its combination.
- the choice of carrier should match the mode of administration, which are well known to those of ordinary skill in the art.
- the first active ingredient (a1) chemokine receptor CCR6 inhibitor provided by the present invention can be combined with the second active ingredient (b1) other than CCR6 inhibitors that can be used to treat psoriasis or its active ingredients Drug combination.
- the second active ingredient (b1) is an anti-epileptic drug that is already available in the prior art, including but not limited to: glucocorticoids, including IL-17A antagonists, TNF-a antagonists, IL-12/ IL-23 antagonist, calcineurin inhibitor, vitamin D3 derivative, or a combination thereof.
- the present invention specifically addresses the recurrence of psoriasis.
- the present invention aims at the redistribution characteristics of pathogenic cells during the recurrence of psoriasis, which is better than general treatment control drugs.
- the present invention can effectively inhibit the redistribution of pathogenic cells, thereby effectively preventing or alleviating the recurrence of psoriasis.
- Example 1 Detection of changes in the expression of related genes in patients with recurrent psoriasis
- GC glucocorticoid
- RNA-seq transcriptome sequencing
- Example 2 Detection of changes in T cell distribution in patients with relapsed psoriasis
- Example 3 Detecting changes in T cell distribution in an animal model of psoriasis treated by GC
- IMQ IMQ to smear all mice for three weeks. Among them, from the 6th day, GC or Vaseline (Vas) was applied to the skin of the mice, and all treatments were stopped on the 21st day. The mice entered a two-week drug withdrawal period, and then applied IMQ again for 7 consecutive days to induce psoriasis recurrence.
- GC or Vaseline Vas
- Example 4 Detection of IL-17 secretion level changes in animal models of psoriasis treated by GC
- ⁇ T cells are the main cells secreting IL-17 in the skin.
- ⁇ T17 cells in the skin and lymph nodes were detected.
- ⁇ T17 cells in the skin may migrate to drainage and distant lymph nodes after GC treatment, and have a memory cell phenotype.
- Example 5 Detection of changes in ⁇ T17 cell levels and IL-17 secretion levels in mice during the withdrawal period
- mice in the experimental group and the control group rested for 2 weeks.
- Example 6 Detection of ⁇ T17 cell level and IL-17 secretion level in a mouse model of psoriasis recurrence
- IMQ was applied again to the experimental group and the control group mice to simulate the recurrence of psoriasis after clinical withdrawal.
- Example 7 Study on the relationship between CCR6 gene knockout and ⁇ T17 cell redistribution
- cytokine receptors CCR6 and CCR2 mediate the migration of ⁇ T17 cells in the occurrence of skin inflammation.
- wild-type mice (WT), CCR6 -/- and CCR2 -/- mice were used to study the above-mentioned mechanism.
- CCR6 gene knockout will inhibit the migration of ⁇ T17 from the skin to the lymph nodes, and it can also inhibit its migration from the lymph nodes to the skin.
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Abstract
L'invention concerne une nouvelle application d'un inhibiteur du récepteur de chimiokine CCR6 dans la prévention de la récurrence du psoriasis. De façon spécifique, l'invention concerne une utilisation de l'inhibiteur du récepteur de chimiokine CCR6 pour préparer une préparation ou une composition qui est administrée à un sujet de façon à empêcher la récurrence du psoriasis chez celui-ci. L'invention concerne également un produit pharmaceutique qui empêche la récurrence du psoriasis. L'utilisation des produits médicamenteux de l'invention peut prévenir ou atténuer efficacement la récurrence du psoriasis.
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EP20837486.8A EP4026561A4 (fr) | 2019-07-08 | 2020-06-12 | Nouvelle application de l'inhibiteur du récepteur de chimiokine ccr6 dans la prévention de la récurrence du psoriasis |
US17/775,618 US20220401459A1 (en) | 2019-07-08 | 2020-06-12 | New application of chemokine receptor ccr6 inhibitor in preventing recurrence of psoriasis |
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CN201910612157.2 | 2019-07-08 | ||
CN201910612157.2A CN112190708B (zh) | 2019-07-08 | 2019-07-08 | 趋化因子受体ccr6抑制剂在预防银屑病复发中的新应用 |
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EP4223289A1 (fr) * | 2022-02-07 | 2023-08-09 | Liangdan Sun | Application de préparation pour inhiber l'expression camk2g dans la préparation d'un médicament pour le traitement du psoriasis |
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- 2019-07-08 CN CN202311150951.2A patent/CN117018202A/zh active Pending
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2020
- 2020-06-12 EP EP20837486.8A patent/EP4026561A4/fr active Pending
- 2020-06-12 US US17/775,618 patent/US20220401459A1/en active Pending
- 2020-06-12 WO PCT/CN2020/095956 patent/WO2021004229A1/fr unknown
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EP4026561A1 (fr) | 2022-07-13 |
CN112190708A (zh) | 2021-01-08 |
EP4026561A4 (fr) | 2023-11-15 |
CN117018202A (zh) | 2023-11-10 |
CN112190708B (zh) | 2023-09-05 |
US20220401459A1 (en) | 2022-12-22 |
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